California Senate President Pro Tem Darrell Steinberg (D-Sacramento) sent a four-page letter late last week to state health officials urging the state to move more slowly in its transition of approximately 860,000 children from the Healthy Families program into Medi-Cal managed care.
The letter to Health and Human Services Secretary Diana Dooley comes on the heels of several similar letters including one sent by 22 members of the U.S. House of Representatives, and another from a coalition of children's health organizations.
The transition is scheduled to begin Jan. 1 with the first phase moving 415,000 children to Medi-Cal plans. The Healthy Families transition must be approved by CMS.
Steinberg and California Assembly Speaker John Pérez (D-Los Angeles) voiced similar concern in a letter in August, but that concern has not abated, Steinberg said, after reviewing a transition strategic plan that was released last week by the state.
"I believe additional planning time is warranted and necessitated with the complexities of this transition," Steinberg wrote. "The Administration's selected transition date[s in January and March] each need to be moved back in order to address several critical issues."
The main concerns, Steinberg said, are network adequacy, continuity of care, mental health care, dental care and the still-pending approval by federal officials.
"Federal approval must be obtained prior to commencement of the transition," Steinberg wrote. "Their approval is necessary for Medi-Cal rates to be finalized, for federal reimbursement to be provided to the state, and for all consumer protections to be verified, among other aspects."
Steinberg also expressed concern about the state's monitoring of the transition and the current uncertainty over health plan rates.
State health officials have repeatedly said they are taking a careful and cautious approach to the transition and they expect federal approval of their transition plan later this month.
The state sent 60-day notices to Healthy Families participants at the start of November and 30-day notices are expected to be received by first-phase families this week.